Radiology Coding Alert

Question: Should I report the LOCM "Q codes" for exams performed in a hospital setting?


Indiana Subscriber

Answer: If you're coding for the radiologist--not the hospital--you shouldn't report low osmolar contrast material codes Q9945-Q9951, because the hospital provides the contrast.

If you code for the hospital, you should charge for the contrast. For an outpatient, you should report the proper Q code (such as Q9945, Low osmolar contrast material, up to 149 mg/ml iodine concentration, per ml) to receive the APC payment associated with the contrast.

For an inpatient, you can charge for the contrast, even though HCPCS Q codes won't appear on the inpatient UB-92.

Check your codes: As of Jan. 1, 2006, you should be reporting LOCM Q codes instead of A4644-A4646 for both physicians and outpatient hospital services. You can find all the details in CMS Transmittal 804, Change Request 4250 online at www.cms.hhs.gov/HospitalOutpatientPPS/Downloads/R804CP.pdf.

Of course some payers are slow to change which codes they accept, so as always, check with your particular payer to determine which LOCM codes to report.

The answers for You Be the Coder and Reader Questions were reviewed by Jackie Miller, RHIA, CPC, senior consultant with Coding Strategies Inc. in Powder Springs, Ga.; and Gary S. Dorfman, MD, FACR, FSIR.